Progressive Changes in Brain Activation in Paraplegia

截瘫患者大脑激活的渐进变化

• 批准号: 7254047
• 负责人: Donald R. Humphrey
• 金额: $ 33.55万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-07-01 至 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7254047
• 关键词: Address; Area; Basal Ganglia; Bilateral; Brain; Brain region; Cerebellum; Cerebral cortex; Communication; Condition; Control Groups; Cues; Data; Electromyography; Employee Strikes; Experimental Designs; Forearm; Functional Magnetic Resonance Imaging; Future; Hand; Hippocampus (Brain); Human; Injury; Knowledge; Leg; Limb structure; Measures; Minor; Motor; Movement; Paralysed; Paraplegia; Pattern; Personal Satisfaction; Pilot Projects; Reporting; Research; Research Personnel; Sampling; Scanning; Spinal Injuries; Structure; Time; Upper Extremity; Visual; Week; association cortex; design; foot; improved; injured; interest; kinematics; neural prosthesis; nonhuman primate; relating to nervous system; research study; sensory feedback; size; visual tracking

DESCRIPTION (provided by applicant): In pilot research using fMRI, we found that voluntary activation of primary motor cortical (Ml) foot/leg areas was retained in paraplegics (Ps) up to 10 yrs after injury, with overlap developing between Ml hand and foot areas (since confirmed by others). More extensive analyses of our scans from 14 Ps and 4 control subjects (Ss) have revealed, however, more striking changes in brain activation patterns than previously reported. Moreover, these changes develop progressively over 15-25 yrs after spinal injury. In control Ss, brain activation is well lateralized and confined to distinct areas during unilateral foot or hand movement. By 6 months to 2 yrs after spinal injury, however, attempts to move one foot now activates supplementary motor and premotor cortex, basal ganglia, and cerebellum bilaterally. By 3-6 yrs after injury, there is some return toward normal patterns of activation in the Ml and SMA, but greater activation now occurs bilaterally in the basal ganglia and in frontal premotor and association cortex. By 12-25 yrs after injury, these changes are much more pronounced. Ml regions previously active during attempted foot movement are now silent, as are previously activated regions of the posterior cerebellum. But bilateral activation increases further in basal ganglia and in premotor/association cortex, and spreads even to hippocampal, limbic, and parieto-occipital-temporal, "higher-order association areas". Thus, we find more global and progressive changes in brain activity when attempts are made to move a paralyzed limb than has been reported in previous studies, where all Ps were analyzed as a single group. But our sample is small. A new study is needed, therefore, in which larger groups with differing injury durations are studied for greater statistical reliability, and in which improved motor tasks and kinematic measures allow for better control of movement parameters and effort. This study will expand our knowledge of how the brain changes progressively over decades to altered communication with the sensorimotor periphery, and could aid in the intelligent design of future therapies.

描述(申请人提供)：在使用功能磁共振成像的初步研究中，我们发现截瘫(Ps)患者在受伤后10年仍能自愿激活初级运动皮质(ML)足部/腿部区域，并在ML手部和脚部区域之间形成重叠(后来得到他人的证实)。然而，我们对14名PS和4名对照受试者(SS)的扫描结果进行了更广泛的分析，发现大脑激活模式发生了比之前报道的更显著的变化。此外，这些变化在脊柱损伤后15-25年内逐渐发展。在对照SS中，在单侧足部或手部运动时，大脑的激活被很好地偏侧，并局限于不同的区域。然而，在脊髓损伤后6个月到2年，尝试移动一只脚现在激活了双侧辅助运动和运动前皮质、基底节和小脑。到损伤后3-6年，ML和SMA的激活模式有所恢复，但现在更大的激活发生在双侧基底节以及额叶运动前和联合皮质。到受伤后12-25年，这些变化更加明显。以前在尝试脚部运动时活跃的ML区域现在是静默的，就像以前激活的小脑后区域一样。但双侧激活在基底节和运动前/联想皮质进一步增强，甚至蔓延到海马区、边缘区和顶枕颞区的“高级联想区”。因此，我们发现，当试图移动瘫痪的肢体时，大脑活动的全局和渐进性变化比以前的研究报告的更多，在以前的研究中，所有的P都作为一个单独的组进行分析。但我们的样本很小。因此，需要进行一项新的研究，研究具有不同受伤持续时间的更大的群体，以获得更大的统计可靠性，并改进运动任务和运动学措施，以便更好地控制运动参数和努力。这项研究将扩大我们对大脑如何在几十年内逐渐变化以改变与感觉运动外围设备的通信的知识，并可能有助于未来疗法的智能设计。